AB0884 THE IMPORTANCE OF RENAL IMPAIRMENT IN SYSTEMIC SCLEROSIS
Authors: L. Božić Majstorović, I. Ovčina
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Systemic sclerosis (SS) is an autoimmune disease characterized by fibrosis and vascular abnormalities. Studies have shown that renal impairment is increased in SS, but this fact is neglected during diagnostic evaluation [1]. As a control group, patients with rheumatoid arthritis (RA) were selected because the renal involvement was as high as 9% although the kidneys were not the target organs in the disease [2]. Comparation of renal function (RF) between patients with SS and RA have not yet been described. <h3>Objectives</h3> The main goal was to detect correlation between clinical features and renal impairment in SS and to compare the renal impairment in patients with SS to patients with RA. <h3>Methods</h3> The 30 patients diagnosed with SS were included in the study. The demographics, modified Rodnan skin score (mRSS), EUSTAR DAI, diffusing capacity for carbon monoxide (DLCO) and immunology parameters were collected. Evaluation of RF was done by using: serum creatinine (SC), creatinine clearance (CC), proteinuria from 24h urine specimen and renal parenchym thickness (RPT) with abdominal ultrasound. To compare the renal impairment, the 30 patients diagnosed with RA without history of glomerulonephritis, diabetes mellitus, hypertension or urinary tract infection were enrolled as a control group. <h3>Results</h3> The 86.7% patients were female, mean age was 57.07±10.41 and mean disease duration was 73.6±68.73 months. Raynaud phenomen had 93.3% patients, digital ulcers (DU) 43.3% and the mean of mRSS was 21.43±9.5. Antinuclear antibodies had 83.3% patients, 46.7% had anti-Scl-70 antibodies and 43.3% had anticentromere B antibodies. The mean of EUSTAR DAI was 4.85±2.56 and DLCO 60.57±16.60. Regarding RF, the mean value of SC was 70.67µmol/l, CC 83.08 ml/min, proteinuria 0.17 g/l and RPT was reduced in 46.7% patients. We correlated clinical features with RF parameters in patients with SS. Significantly reduced RPT was observed in patients with higher mRSS (p=0.035) and in patents with DU (p=0.05). No association was observed between RF and other clinical features. Our results showed significant difference in all RF parameters, between patient and control group. SC (p=0.004) and proteinuria (p=0.03) were significantly higher in SS compared with RA. CC was significantly higher in RA than in patients with SS (p=0.005). RPT was significantly reduced (p=0.000) in SS compared to patients with RA. The results are displayed in Table 1. <h3>Conclusion</h3> Presence of DU and high values of mRSS can be asocciated with renal damage and that indicates the need for evaluation of the RF. The renal impairment in our study was more significant in patients with SS than in those with RA. More studies are necessary to establish this correlation. <h3>References</h3> [1]Gigante A, Barbano B, Gasperini ML, Zingaretti V, Cianci R, Rosato E. Renal Parenchymal Thickness in Patients with Systemic Sclerosis Is Related to Intrarenal Hemodynamic Variables and Raynaud Renal Phenomenon.The Journal of Rheumatology.2020;47:4 [2]Hickson LJ, Crowson CS, Gabriel SE, McCarthy JT, Matteson EL. Development of reduced kidney function in rheumatoid arthritis. Am J Kidney Dis.2014;63(2):206–13 <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.